Transitioning into Hospital Based Practice: A Guide for Nurse Practitioners and Administrators

Barriers to NP Practice that Impact Healthcare Redesign
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Recommendation 7: One degree title should be chosen to represent practice-focused doctoral programs that prepare graduates for the highest level of nursing practice.

A new and higher level of preparation for advanced practice nursing is justified if and only if it results in sufficient knowledge and skill above that already included at the master's level. Program content and graduates' competencies clearly must go beyond those of current master's programs. Given the increasing complexity and sophistication of health care, the Task Force members and stakeholders who provided input to the Task Force were confident that the additional education is well justified and does represent added value.

The specialty competencies developed for the proposed DrNP graduate who will be providing direct care to individuals , for example, "are built upon and expand the competencies of the master's prepared nurse practitioner" Committee on DrNP Competencies, , p. Given the tremendous time, credit and clinical experience required for master's degree APN programs , serious consideration should be given to moving toward the practice doctorate as the graduate degree for APN preparation. Because a major shift of this kind will not occur in the immediate future, it will be necessary to provide an extended transition period during which nurses with master's degrees would be recognized to be fully credentialed for current advanced practice roles.

A challenge will be to identify, using an evidence-based approach, the curricular standards associated with both master's and doctoral APN education and provide for a seamless interface between educational programs. In addition, after advanced clinical competencies of the practice doctorate are identified, a standardized method for validating these competencies should be established. During the transition period, it will be necessary to ensure multiple entry points into practice-focused doctoral programs.

With an extended transition period and accessible programs, APNs, currently practicing in one of the four APN roles, who wished to obtain the doctoral degree would be provided the opportunity to earn a practice doctorate. Another identified concern is the cost in time and resources, particularly financial resources, required to upgrade one's credentials.

Other disciplines, e. A variety of approaches to ease the transition should be developed to allow APNs to advance their education and degree title. A final concern that has been identified is the economic impact of such an educational shift on the labor market for APNs. This impact should be taken into account as plans are made for the transition period to ensure a feasible and sustainable shift in educational preparation for advanced practice nurses.

The Task Force believes that the benefits of such a move will outweigh the costs but recognizes that the transition plan will need to take into account the timing of costs and benefits. Recommendation The practice doctorate be the graduate degree for advanced nursing practice preparation, including but not limited to the four current APN roles: clinical nurse specialist, nurse anesthetist, nurse midwife, and nurse practitioner. Recommendation A transition period be planned to provide nurses with master's degrees, who wish to obtain the practice doctoral degree, a mechanism to earn a practice doctorate in a relatively streamlined fashion with credit given for previous graduate study and practice experience.

The transition mechanism should provide multiple points of entry, standardized validation of competencies, and be time limited. Preparation for the Clinical Educator and Faculty Roles. A practice-doctoral degree in nursing would prepare nurses with advanced preparation and specialized knowledge in one identified area of nursing practice.

The discipline of education encompasses an entirely separate body of knowledge and competence. Many nursing practice doctoral graduates may choose the educator role. Graduates of practice doctoral programs will have expertise and preparation for the highest level of nursing practice. Preparation to teach at the collegiate level, as in other disciplines, requires preparation with a terminal degree.

However, just as for graduates of research-focused doctoral programs, graduates of practice-focused nursing programs may need additional education in the educator role and pedagogical methodologies AACN, Recommendation Practice doctorate programs, as in research-focused doctoral programs, are encouraged to offer additional coursework and practica that would prepare graduates to fill the role of nurse educator.

Accreditation and Regulation. Accreditation and regulation are complex issues. The quality of research-focused doctoral programs is ensured through ongoing review and quality assessment, which are generally carried out by the graduate school or comparable entity of the offering institution. Practice-focused doctoral programs, like master's programs, prepare graduates for specialized professional practice that is regulated by agencies charged with protecting the safety of the public.

The quality of practice-focused doctoral programs, their ability to produce graduates with the requisite competencies for advanced practice, and their adherence to high standards of professional education must be scrutinized and ensured by professional nursing accrediting bodies. It also is recognized that a change in the educational requirements for APN practice could impact certification and regulation.

Stakeholders representing certifying and regulatory bodies, however, have indicated that the specific impact and need for change in these arenas cannot be identified at this point in the transition phase. These individuals further indicate that, as outcome-based competencies are identified and programs evolve, certification and regulatory changes will follow. Recommendation Practice-focused doctoral programs need to be accredited by a nursing accrediting agency recognized by the U. Secretary of Education.

The Task Force recommends:.

Announcements

The term practice doctorate be used instead of clinical doctorate. The practice-focused doctoral program be a distinct model of doctoral education that provides an additional option for attaining a terminal degree in the discipline. Practice-focused doctoral programs prepare graduates for the highest level of nursing practice beyond the initial preparation in the discipline.

Practice-focused doctoral nursing programs include seven essential areas of content. Practice-focused doctoral nursing programs prepare leaders for nursing practice. One degree title be chosen to represent practice-focused doctoral programs that prepare graduates for the highest level of nursing practice. The Doctor of Nursing ND degree title be phased out. The practice doctorate be the graduate degree for advanced nursing practice preparation, including but not limited to the four current APN roles: clinical nurse specialist, nurse anesthetist, nurse midwife, and nurse practitioner.

A transition period be planned to provide nurses with master's degrees, who wish to obtain the practice doctoral degree, a mechanism to earn a practice doctorate in a relatively streamlined fashion with credit given for previous graduate study and practice experience. Practice doctorate programs, as in research-focused doctoral programs, are encouraged to offer additional coursework and practica that would prepare graduates to fill the role of nurse educator.

Practice-focused doctoral programs need to be accredited by a nursing accrediting agency recognized by the U.

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Kathleen Andreoli Rush University. Catherine Gilliss Yale University. Sandra Edwardson University of Minnesota. Judy Honig Columbia University. Julie Sebastian University of Kentucky. The exact charge to the member Task Force on the Clinical Doctorate was: clarify the purpose of the professional clinical doctorate, specifically core content and core competencies; describe trends over time in clinical doctoral education; assess the need for clinically focused doctoral programs; identify preferred goals, titles, outcomes, and resources; discuss the elements of a unified approach versus a diverse approach; determine the potential implications for advanced practice nursing APN programs; make recommendations regarding related issues and resources; and describe potential for various tracks or role options.

To address this charge the Task Force carried out the following activities: reviewed literature regarding professional practice doctorates in nursing and other disciplines and printed materials and web pages from all institutions offering practice-focused doctoral programs in nursing; established a collaborative relationship with the National Organization of Nurse Practitioner Faculty NONPF ; the Chair of the NONPF Practice Doctorate Task Force, Dr.

Nursing has many of the answers to the predominant health care dilemmas of the future, including: the problems associated with normal human development, particularly aging; chronic illness management in all ages; health disparities associated with socioeconomic dislocations such as global migration, classism, sexism; and the need for health promotion and disease prevention.

ISBN 13: 9780826157324

Need and Perceived Benefits During the past three decades the doctorate has become firmly established as the terminal degree in nursing. Based on this information, two challenges are evident: Master's prepared advanced practice nurses identify additional knowledge that is needed for a higher level of advanced practice. The time spent in master's level nursing education is not congruent with the degree earned.

Based on input from several stakeholder groups, including attendees at the AACN master's and doctoral conferences, the NONPF annual meeting, the NONPF teleweb conference, the Committee on Institutional Cooperation CIC deans' group , the multi-disciplinary group attending the invitational DrNP planning conferences convened by Columbia University, and the National Forum co-hosted by AACN and NONPF, benefits of practice-focused doctoral programs include: development of needed advanced competencies for increasingly complex clinical, faculty and leadership roles; enhanced knowledge to improve nursing practice and patient outcomes; enhanced leadership skills to strengthen practice and health care delivery; better match of program requirements and credits and time with the credential earned; provision of an advanced educational credential for those who require advanced practice knowledge but do not need or want a strong research focus e.

Issues and Challenges.

Barriers to NP Practice that Impact Healthcare Redesign

Unified Versus Diverse Approach Among the most difficult issues is whether all programs should adopt a standardized purpose and set of expected competencies for graduates. Degree Titles. However, due to the confusion that continues to surround the Doctor of Nursing ND degree and to standardize the degree title conferred by all practice-focused nursing doctoral programs, the following recommendations are made: Recommendation 7: One degree title should be chosen to represent practice-focused doctoral programs that prepare graduates for the highest level of nursing practice. Relationship to Current Advanced Practice Nursing Program A new and higher level of preparation for advanced practice nursing is justified if and only if it results in sufficient knowledge and skill above that already included at the master's level.

Preparation for the Clinical Educator and Faculty Roles A practice-doctoral degree in nursing would prepare nurses with advanced preparation and specialized knowledge in one identified area of nursing practice. Accreditation and Regulation Accreditation and regulation are complex issues. Summary of Recommendations.

The Task Force recommends: 1. Task Force on the Practice Doctorate in Nursing. American Association of Colleges of Nursing. Education models to prepare the clinical nurse leader. Working paper on the role of the clinical nurse leade r. Position statement on quality indicators for doctoral programs. USD Sign in to Purchase Instantly.

Background

Nov 20, Transitioning into Hospital Based Practice|"This is a unique and is a wonderful guide for nurse practitioners and administrators working to. Transitioning into Hospital Based Practice: A Guide for Nurse Practitioners and Administrators: Medicine & Health Science Books.

Temporarily Out of Stock Online Please check back later for updated availability. Overview This is a unique and needed addition to the nursing literature. About the Author At the time of this project's inception, Mona N. Bahouth has extensive experience in developing programs for NPs dating back to when she developed the first hospital wide NP group at the University of Maryland.

She has published and lectured extensively on multiple topics including the process of NP transition into hospital based practice. These experiences were the impetus for the development of this text. Show More. Average Review. Geriatric and Gerontological. Maternal, Neonatal, Women's Health. MedSurg and Acute Care Nursing.

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